Healthcare Provider Details
I. General information
NPI: 1396465688
Provider Name (Legal Business Name): CROSSING CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/29/2022
Last Update Date: 05/25/2024
Certification Date: 05/25/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3141 S MILITARY TRL STE 108
LAKE WORTH FL
33463-2133
US
IV. Provider business mailing address
3141 S MILITARY TRL STE 108
LAKE WORTH FL
33463-2133
US
V. Phone/Fax
- Phone: 561-202-8896
- Fax: 561-202-8897
- Phone: 561-202-8896
- Fax: 561-202-8897
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JUPITER
FLEURIMON
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 561-574-9087